MEDICARE: STACIA STOKES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1346662897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIA STOKES

Provider Business Mailing Address
First Line	:	6655 BOULDER HWY
Second Line	:	1191
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-7418
Country	:	US
Telephone Number	:	330-323-9518
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 BOULDER HWY APT 1191
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-7733
Country	:	US
Telephone Number	:	330-323-9518
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2014
Last Update Date	:	01/16/2014

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Directions to “ STACIA STOKES ” Practice Location

Language	Start Address	Practice Location

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